| NPI | 1104310572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8619-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 173814-030) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-10-08 |